older persons, productive activities, subjective well-being,

OBJECTIVEEvidence has shown that Mexican Americans have a higher prevalence of diabetes and a greater risk for diabetes-related complications than non-Hispanic whites. However, no studies have described the changes in prevalence among older Mexican Americans. The purpose of this study was to expand on the current literature by examining the trends in diabetes prevalence and diabetes-related complications in Mexican Americans aged ≥75 years from 1993–1994 to 2004–2005.RESEARCH DESIGN AND METHODSThe prevalences of self-reported diabetes and diabetes-related complications were estimated in the original cohort (1993–1994) and the new cohort (2004–2005) of the Hispanic Established Population for the Epidemiologic Study of the Elderly (Hispanic EPESE) and were compared across the two surveys.RESULTSThe prevalence of diabetes among Mexican Americans aged ≥75 years has nearly doubled between 1993–1994 and 2004–2005 from 20.3 to 37.2%, respectively (P < 0.001). The increase in the prevalence of diabetes was similar across all sociodemographic factors. Diabetes complications did not change significantly between the two cohorts. However, the prevalence of having any lower-extremity function disability did increase between the two cohorts.CONCLUSIONSThe prevalence of diabetes in older Mexican Americans has increased dramatically. At the same time, there has been no improvement in diabetes-related complications as has been found in the general older population. These findings heighten the urgency for more effective public health interventions targeted to this population. As diabetes and obesity become more prevalent in older adults, physicians should encourage appropriate management in older patients, including early detection and glycemic control.

Research indicates that neighborhood context can have a significant effect on the health of elders. The evidence suggests that there may be physical health benefits afforded to Mexican Americans living in ethnically homogenous neighborhoods, despite the relatively high economic risk in such neighborhoods. However, few studies have considered the impact of neighborhood ethnic density on mental health outcomes in older adults. This study evaluates the association between neighborhoods with a high proportion of Mexican Americans and depressive symptoms among very old Mexican Americans. Hierarchical linear modeling was used to examine data from Wave 5 (2004–2005) of the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE). Subjects included 1,875 community-dwelling Mexican Americans aged 75 and older living in 386 neighborhoods across five states in the Southwestern United States (Arizona, California, Colorado, New Mexico, Texas). Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D, α =0.88). Results showed that among very old men, there was a significant negative association between percent Mexican Americans in the neighborhood and depressive symptoms (P=.011). Although among women the direction of the association was the same, the effect was not significant. These findings suggest that the proportion of Mexican Americans in the neighborhood matter more for very old Mexican American men than women. Further research may inform screening and treatment for depressive symptoms based on differences in neighborhood composition. Recommendations include culturally tailored programs that offer older Mexican Americans greater mobility and access to programs and opportunities in culturally identifiable neighborhoods.